Defense and Veterans Brain Injury Center, Silver Spring, Maryland (Drs Remigio-Baker, Bailie, Gregory, Cole, Stuessi, Ettenhofer, and Mullins and Ms Andrews); Naval Hospital Camp Pendleton, Concussion Care Clinic, Camp Pendleton, California (Drs Remigio-Baker, Bailie, and Stuessi); Venesco LLC, Chantilly, Virginia (Drs Remigio-Baker and McCulloch and Ms Andrews); General Dynamics Health Solutions, Silver Spring, Maryland (Drs Bailie and Stuessi); Naval Medical Center San Diego, San Diego, California (Ms Andrews and Drs Mullins and Ettenhofer); Department of Brain Injury Medicine, Womack Army Medical Center, Fort Bragg, North Carolina (Drs Cole and Cecchini); Department of Allied Health Sciences, The University of North Carolina at Chapel Hill (Dr McCulloch); and American Hospital Services Group, LLC, Exton, Pennsylvania (Dr Ettenhofer).
J Head Trauma Rehabil. 2020 Mar/Apr;35(2):92-103. doi: 10.1097/HTR.0000000000000498.
To evaluate the impact on symptom resolution of activity acutely following a concussion and the role of acute-phase symptoms on this relationship among active duty service members (SMs).
Three military installations.
Sixty-two SMs aged 18 to 44 years who sustained a concussion within 72 hours of enrollment.
Longitudinal design with data collected within 72 hours of injury (baseline, n = 62) and at 1 week (n = 57), 1 month (n = 50), 3 months (n = 41), and 6 months (n = 40) postinjury.
Baseline activity level using a 60-item Activity Questionnaire. Symptom level at baseline and during follow-up using Neurobehavioral Symptoms Inventory.
Significant interaction (Pi < .05) was found, with significant main effects (P < .05) limited to SMs with elevated baseline symptomatology. Among these participants, greater baseline total activity was significantly related to greater vestibular symptoms at 1, 3, and 6 months (β = .61, .63, and .59, respectively). Significant associations were also found for particular types of baseline activity (eg, physical; vestibular/balance; military-specific) and symptoms at 1, 3, and/or 6 months postinjury.
These results provide support for clinical guidance that symptomatic SMs, particularly those with high levels of acute symptoms, may need to avoid excessive activity acutely following concussion.
评估活动对急性脑震荡后症状缓解的影响,以及急性期症状在此关系中的作用,对象为现役军人(SM)。
三个军事设施。
62 名年龄在 18 至 44 岁之间的 SM,在入组后 72 小时内发生脑震荡。
具有数据收集的纵向设计,包括损伤后 72 小时内(基线,n=62)和 1 周(n=57)、1 个月(n=50)、3 个月(n=41)和 6 个月(n=40)时。
使用 60 项活动问卷评估基线活动水平。使用神经行为症状量表评估基线和随访期间的症状水平。
发现了显著的交互作用(Pi <.05),只有基线症状较高的 SM 具有显著的主要效应(P <.05)。在这些参与者中,较高的基线总活动与 1、3 和 6 个月时的前庭症状显著相关(β =.61,.63 和.59)。在基线时的特定活动类型(如身体活动、前庭/平衡、军事特定活动)和 1、3 和/或 6 个月时的特定症状之间也发现了显著的关联。
这些结果为临床指导提供了支持,即症状性 SM,特别是那些急性期症状水平较高的患者,可能需要在脑震荡后立即避免过度活动。